We examined the psychosocial, demographic, and clinical correlates of familial subtypes of primary unipolar depression. Our findings supported the hypothesis that depression spectrum disease is a variant of neurotic depression, whereas familial pure depressive disease overlaps with endogenous depression. Patients with depressive spectrum disease experienced more life events, had more marital separations and divorces, had poorer social support, more frequently made a nonserious suicide attempt, and had a less characteristic endogenous symptom profile than patients with familial pure depressive disease. Consistent with our previous report on the relationship between dexamethasone suppression test results and familial subtyping, the broadness of the criteria used to diagnose the patients' first-degree relatives affected the strength of the association between the familial subtypes and the dependent variables.